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Case Report: Atrioventricular block deterioration during general anesthesia induction in a patient with coronary heart disease complicated by first-degree atrioventricular block and complete right bundle branch block

Year: 2026

Type: article

Abstract: Coronary artery disease complicated by first-degree atrioventricular block and complete right bundle branch block suggests potential bilateral bundle branch involvement, substantially increasing the risk of severe conduction disturbances during the perioperative period. We report the case of a patient with severe coronary atherosclerosis whose preoperative electrocardiogram revealed first-degree atrioventricular block combined with complete right bundle branch block. Following induction of general anesthesia, the atrioventricular block deteriorated precipitously, prompting postponement of the elective procedure. The patient subsequently underwent successful distal subtotal radical gastrectomy with temporary pacemaker support. This case highlights that anesthesia induction may precipitate or exacerbate atrioventricular block in such patients. For individuals undergoing high-risk noncardiac surgery, comprehensive preoperative assessment of cardiac conduction system function, rigorous dynamic rhythm monitoring, and pre-established rescue strategies including temporary pacemaker placement are warranted.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2026.1999954

Authors: Qian-qian Zhao, Xiao-li Liu

Institution: Affiliated Hospital of Jining Medical University

Language: English

Topic: Cardiac, Anesthesia and Surgical Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801